If, for some reason, such as injury, insult, surgery, disease, or the like, the neurological functioning of a patient is interrupted, it has been found that such patient loses some portion of his ability to recognize the spatial position and orientation of his body and/or parts thereof with respect to itself and/or the surroundings. It is noted that for the purposes of this disclosure, the term "interruption of neurological functions" is intended to include, not only the occurrences listed above, but any occurrence that affects the neurological or muscularskeletal system of a patient.
This loss of ability is often manifested in a loss of the ability to properly walk, stand, sit, establish and hold proper posture, or to execute gross motor sequential movements, such as rolling and the like. For example, the stroke or disease patient may not be able to walk with a normal gait, or may sit at an angle without knowing of the irregularity. In fact, such a patient may be sitting at an angle with respect to the normal upright orientation, and feel as though he is in a perfectly proper position and orientation, or may walk with an extremely exaggerated leg movement thinking that he is executing a normal gait.
For these reasons, as well as others which will be known to those skilled in the art of biomechanics and perceptual motor training, the field of biomechanics has developed several techniques and devices for retraining such a patient to establish normal body positioning and orientation.
Examples of such techniques and devices include parallel bars, walkers, treadmills, devices attached to the patient, such as electrodes or the like, video cameras, assistants, ice and heat baths and the like.
While all of these known devices and techniques have been somewhat effective, they have not been entirely successful because they do not fully duplicate the real-life conditions to which the patient will be subjected, and thus do not efficiently train the patient in a manner that will permit that patient to adapt to all of the myriad of situations encountered in his normal everyday living so that he can execute normal body movements in those situations to which he may be subjected in real life, even if those particular situations are not the subject of any specific portion of his training. In other words, the present techniques and devices do not efficiently train the patient in a manner which makes that patient fully independent of such devices and techniques, and, as will be discussed below, the patient may actually come to rely on the device and/or technique and not be able to function on his own in the most effective and efficient manner, especially in those situations which have not been duplicated in the training sessions. Furthermore, these devices and techniques are not versatile or mobile enough to satisfy all of the plethora of circumstances which require rehabilitation.
For example, many of the presently available devices and techniques must be located at a rehabilitation center such as in a hospital or the like, and many patients are bedridden and cannot even get to such centers. Still further, such centers do not, and cannot duplicate real-life situations, and thus the patient is subject to conditions in real life that he may not be fully ready for. Since the devices and techniques must be located at specific locations, scheduling problems may occur thereby prohibiting some patients from taking full advantage of a rehabilitation center.
Another disadvantage of such artificial conditions is that many of the techniques and devices are condition-specific. That is, a particular device or technique is designed for a specific condition, such as correcting the patient's gait, and is not effective for other conditions, such as a head position while sitting and/or walking. Not only is this extremely expensive for the rehabilitation center since much more equipment is required, it is not fully efficient since any movement of a patient's body usually involves many different motor skills. The patient is forced to learn an overall movement in bits and pieces which is extremely inefficient and may be discouraging as well. This problem is then exacerbated when the skill is finally learned, and the patient then encounters a different environment in a real life situation, such as in a grocery store, or the like. Learning to walk on a parallel bar device is not the same thing as walking down an aisle at a grocery store.
In addition to the above, and possibly more detrimental to the effectiveness of presently known devices and techniques, is the requirement that all such devices have some sort of physical, or tactile, contact with the patient to signal him of an erroneous motor controlled movement. For example, in such a tactile process, a technician standing next to the patient while that patient learns to stand in an upright position actually physically moves the patient back into a proper position as soon as the patient leans, or an electrode placed on the patient's body causes some sort of signal when that body part is out of normal orientation.
This tactile process has several disadvantages. First, the touching of the body part being trained signals that exact body part externally and excites a portion of the nervous system that is different from the portion of the nervous system used when there is no such external signal. The patient then may learn to wait for the external signal to identify the portion of the body that is in error rather than learning to identify that body part on his own. This slows the learning process.
In addition to slowing the learning process due to the signalling of exactly what portion of the body is in error instead of teaching the patient to identify the error himself, this tactile method may actually teach the patient to rely on being told when he is improperly executing a motor function, and teach him to lean on the assistant, both physically and mentally.
It has been found that due to the reliance on touching, many rehabilitation sessions must go back over the prior sessions, and re-train the patient because the patient has forgotten the prior lessons. It has been found that a retention of learned responses can be as low as twenty percent. Such low retention is extremely inefficient and discouraging to both the patient and to the therapist.
In addition to the above, in some cases, the patient may even have a tactile defensiveness. That is, the patient may actually reject a physical touching.
Again, such tactile procedure does not duplicate the real life conditions to which the patient will be subjected. Having an assistant or a parallel bar or other such physical presence touch and move your leg into the proper position whenever it moves out of such position is not the same as walking from your automobile or standing in a line.
Thus, there is need for a perceptual motor training device and method applicable to efficiently retrain a patient to recognize, using his own, unaided, internal systems, the spatial and/or orientational position(s) of his body and/or the parts thereof after an interruption of the neurological functions of that patient which is versatile and which duplicates real-life situations so as to efficiently teach a patient to identify, using his own internal systems, the various parts of his body being moved and controlled and to efficiently make a patient independent of the training device and/or technique.